MEDICARE: DR. TARA B STEIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	239564	NY

General Provider Information

NPI Number	:	1982815163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA B STEIN MD

Provider Business Mailing Address
First Line	:	3380 RESERVOIR OVAL E
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-3101
Country	:	US
Telephone Number	:	718-696-4060
Fax Number	:

Provider Business Practice Location Address
First Line	:	3544 JEROME AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-1005
Country	:	US
Telephone Number	:	718-515-5416
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2007
Last Update Date	:	03/05/2014

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